Browsing by Author "Okur F."

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    Short- and mid-term results of balloon angioplasty in the treatment of aortic coarctation in children; [Çocuklarda aort koarktasyonu tedavisinde balon anjiyoplastinin kisa ve orta dònem sonuçlari]
    (2008) Okur F.; Tavli V.; Santaş T.; Talat Tavli M.
    Objectives: We evaluated short- and mid-term results of balloon angioplasty performed in pediatric patients with aortic coarctation. Study design: The study included 20 children (12 boys, 8 girls; mean age 3.4±3.7 years; range 15 days to 13 years) who underwent balloon angioplasty for aortic coarctation. The patients were assessed by transthoracic echocardiography for left ventricular functions and recoarctation within a mean follow-up period of 19.6±15.3 months (range 1 to 48 months). Results: The mean peak systolic gradients were 49.8±14.7 mmHg and 9.3±11.1 mmHg before and just after balloon angioplasty, respectively (p<0.05). Decrease in the gradients was not sufficient in three cases. During the follow-up period, transient loss of lower extremity pulses was seen in two cases, and a small aneurysmal formation in one case. Procedure-related mortality did not occur. The mean left ventricle mass index decreased by 4.3% following the procedure (p>0.05). Despite successful balloon angioplasty, hypertension persisted in two cases whose ages were 11 and 13 years, respectively. Restenoses were observed in five cases within a mean of six months, which were dealt with by surgical resection and end-to-end anastomosis in four cases, and by subclavian flap angioplasty in one case. Despite surgical resection-anastomosis and subclavian flap angioplasty, two patients developed restenosis, for which repeat balloon angioplasty was planned. Conclusion: Considering its short- and mid-term results, balloon angioplasty is a successful and reliable procedure in the treatment of aortic coarctation.
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    Myocardial performance after successful intervention for native aortic coarctation
    (2010) Tavli V.; Saritas T.; Guven B.; Okur F.; Saylan B.C.; Tavli T.; Uyanik B.S.; Ari Z.; Isbilen B.
    Coarctation of the aorta is associated with increased risk for hypertension in adulthood, despite successful repair. The intrinsic mechanisms underscoring hypertension and left ventricular performance in these patients, however, remains to be determined. Our objective was to evaluate left ventricular performance by means of echocardiographic and biochemical parameters at midterm follow-up in normotensive children who have had undergone successful surgical or catheter interventional treatment of coarctation with a residual gradient of less than 20 mmHg at rest. We studied prospectively 14 patients with native aortic coarctation who underwent surgery or balloon angioplasty, the cohort made up of equal numbers of boys and girls, and having a mean age of 8.5 plus or minus 4 years. We also studied 30 age-matched healthy subjects, measuring mitral inflow pulsed wave signals, isovolumic relaxation and contraction times, myocardial performance index parameters, and levels of B-type natriuretic peptide and endothelin-1 in both groups. We found no differences in systolic blood pressure at rest between the patients and their controls. The ventricular septal diastolic dimensions, left ventricular posterior wall dimensions, mitral valve E wave, deceleration time, isovolumic relaxation time, isovolumic contraction time and myocardial performance index were all significantly increased in the patients. Levels of plasma B-type natriuretic peptide and endothelin-1 were also significantly higher in the patients when compared to the control group. We conclude that aortic coarctation is a chronic disease characterized by persistency of myocardial and vascular alterations. The elevated levels of plasma b-type natriuretic peptide and endothelin-1 may be indicative of late onset hypertension after successful treatment of native coarctation in early childhood. © Cambridge University Press 2010.